130 districts across India, including six metros, in COVID-19 Red Zone list

As many as 130 districts -- including all the major metro cities -- have been identified as "red zones" and another 284 districts as "orange zones" by the Union Ministry of Health & Family Welfare as part of the plan to contain the spread of the coronavirus (COVID-19) pandemic in the country.

The remaining 319 districts in the country are designated as "green zones" for the week after May 3, when the nationwide extended lockdown will come to an end, according to a list drawn up by the Ministry.

There is speculation that the Government will announce "considerable relaxations" in the green zone districts while continuing with the restrictions in the red zone districts. Some relaxations are also likely in the orange zone districts.

Union Health Secretary Preeti Sudan wrote to the Chief Secretaries of all States yesterday and said that it was important to ensure that pockets of critical intervention are identified for a focused management of COVID-19 at the field level. In this context, she referred to the video conference held by Cabinet Secretary Rajiv Gauba with the Chief Secretaries and Health Secretaries of all States yesterday.

"The districts were earlier designated as hotspots/red zones, orange zones and green zones primarily based on the cumulative cases reported and the doubling rate. Since recovery rates have gone up, the districts are now being designated across various zones duly broad-basing the criteria. This classification is multi-factorial and takes into consideration incidence of cases, doubling rate, extent of testing and surveillance feedback to classify the districts. A district will be considered under Green Zone, if there are no confirmed cases so far or there is no reported case since last 21 days in the district," Sudan wrote in her letter.

"Some states have raised issues on inclusion of certain districts in red-zone. I would like to highlight that this is a dynamic list. The list will be revised on a weekly basis or earlier and communicated to states for further follow-up action in consonance with the directions issued by Ministry of Home Affairs under the Disaster Management Act, 2005.

"It is further highlighted that based on field feedback and additional analysis at state level, states may designate additional red or orange zones as appropriate. However, states may not relax the zonal classiflcation of districts classifled as red/orange as communicated by the Ministry," she said.

She said that, for the districts having one or more municipal corporations, the corporations and other areas of districts may be treated as separate units. If one or more of these units have reported no cases for last 21 days, they can be considered as one level lower in zonal classiflcation, in case the district is in Red/Orange Zone. District authorities should, however, exercise due caution in such areas so that these areas remain free from COVID-19 cases.

"It is critical to ensure that necessary action for containment so as to break the chain of transmission of virus is initiated in both red and orange zone districts reporting confirmed cases," she emphasised.

Sudan said the containment zones in these districts have to be delineated based on mapping of cases and contacts; geographical dispersion of cases and contacts; area with well demarcated perimeter; and enforceability.

"Depending on above factors, for urban areas residential colony/ mohallas/ municipal wards or police-station area/municipal zones/ towns etc. as appropriate can be designated as containment zones. Similarly, for rural areas -- villages/ clusters of villages or group of police stations/ gram panchayats/ blocks etc. as appropriate can be designated as containment zones. The area should be appropriately defined by the district administration/ local urban body with technical inputs from local level. In the spirit of effective containment, it is advisable to err on the side of caution," she said.

The Health Secretary said a buffer zone around the containment zone has to demarcated. Necessary action should then be initiated in these areas as part of the Containment Action Plans already communicated including stringent perimeter control; establishing clear entry and exit points; no movement except for medical emergencies and essential goods and services; no unchecked influx of population; people transiting to be recorded & followed through Integrated Disease Surveillance Programme (IDSP); active search for cases through house to house surveillance by special teams formed for the purpose; testing of all cases as per sampling guidelines; contact tracing; and clinical management of all confirmed cases,'

Similarly, in buffer zones, extensive surveillance for cases through monitoring of influenza-like illnesses (ILI) and severe acute respiratory infection (SARI) cases in health facilities has to be taken up, the letter said.

"All States are accordingly requested to delineate the containment zones and buffer zones in the identified red and orange zone districts and notify the same," Sudan added.

Among the major cities in the red zone are the metro cities of Delhi, Mumbai, Chennai, Kolkata, Bengaluru and Hyderabad.

Of the 130 districts in the Red Zone, Uttar Pradesh accounts for the most at 19, followed by 14 in Maharashtra, 12 in Tamil Nadu, all 11 in Delhi, 10 in West Bengal, nine each in Gujarat and Madhya Pradesh, eight in Rajasthan, six in Telangana, five each in Andhra Pradesh and Bihar, four in Jammu and Kashmir, three each in Karnataka, Odisha and Punjab, two each in Haryana and Kerala, and one each in Andaman & Nicobar Islands, Chandigarh, Chhattisgarh, Jharkhand and Uttarakhand.